Lower Limb
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno in Understanding Human Anatomy and Pathology, 2018
The anterior (developmentally dorsal, or extensor) compartment of the thigh includes six muscles: the iliopsoas, the sartorius, and the four muscles that form the quadriceps femoris: the rectus femoris, vastus lateralis, vastus intermedius, and vastus medialis (Plate 5.5a; Table 5.2). The iliopsoas is a composite muscle that mainly flexes the thigh and is formed by two fused muscles: the iliacus (mainly innervated by the femoral nerve) and the psoas major (mainly innervated directly by lumbar nerves of the lumbar plexus). The four muscles that make up the quadriceps femoris (quad = four) extend the leg. The rectus femoris is also able to flex the thigh because it originates from the pelvis and not from the femur as do the vastus lateralis, intermedius, and lateralis. The name “sartorius” comes from the Latin word sartor, which means tailor, and the sartorius accordingly is often called the tailor’s muscle. Its name indicates its three main functions—from anatomical position, you need to perform three movements to sit in the cross-legged posture of early tailors: First you flex the thigh, then you flex the leg, and lastly you laterally rotate the thigh (but not abduct the thigh, as is sometimes stated in anatomical texts). Rather than memorizing the functions of the sartorius, you can logically deduce them: The muscle lies mainly anterior, not lateral, to the femur, so it mainly flexes—not abducts—the thigh. Its fibers are directed distomedially, in an appropriate direction to laterally rotate the thigh. Lastly, its fibers pass posterior to the knee joint, giving it the ability to flex the leg.
Radiology of Infectious Diseases and Their Potential Mimics in the Critical Care Unit
Cheston B. Cunha, Burke A. Cunha in Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
The iliopsoas compartment is located between the spine and the retroperitoneal organs and constitutes an important anatomic conduit of disease from the thorax to the pelvis and proximal femur. Diseases of the psoas often present with vague abdominal complaints, with painful hip flexion deformity present in less than half of patients. Psoas abscess is defined as primary when there is no local cause identified, and it is then usually attributed to hematogenous spread of a distant, and sometimes occult, infectious process. It is associated with immunosuppression, diabetes, and/or drug abuse. The most common causative pathogen is S. aureus. Secondary psoas abscess is more common in immunocompetent patients and is due to local infectious spread from the intestines, kidneys, or bone. It is usually polymicrobial. Fistulizing Crohn disease is reportedly the most common cause. Iatrogenic causes of psoas abscess include urologic surgeries and surgeries on the lumbar or hip areas. Underlying retroperitoneal space malignancy is a very rare cause of secondary psoas abscess [16,17].
The neurological examination
Michael Y. Wang, Andrea L. Strayer, Odette A. Harris, Cathy M. Rosenberg, Praveen V. Mummaneni in Handbook of Neurosurgery, Neurology, and Spinal Medicine for Nurses and Advanced Practice Health Professionals, 2017
Iliopsoas muscle: Psoas and iliacus muscles (Figure 11.2a) Innervation: Upper part of iliac fossa to lesser trochanter (iliacus). Psoas major: Lumbar nerves (L1, L2, and L3).Iliacus: Femoral nerve (L2 and L3).Function: Flexion of hip joint.Physical examination: The patient lies supine with the leg flexed at the knee and hip and tries to flex the thigh against resistance.
Effects of backrest and seat-pan inclination of tractor seat on biomechanical characteristics of lumbar, abdomen, leg and spine
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Qichao Wang, Yihuan Huo, Zheng Xu, Wenjie Zhang, Yujun Shang, Hongmei Xu
In this study, the muscles with high activities, including gluteus maximus, semitendinosus, Rectus femoris, iliopsoas, vastus lateralis and sartorius, were analyzed, and those muscles with low activities or small muscle tissues were not taken into account. Gluteus maximus has a wide and thick quadrilateral shape, and mainly drives the extension and external rotation of the thigh. Semitendinosus is located at the back of the thigh and helps the extension of the hip joint and bending of the knee joint. Rectus femoris is located in the front of the thigh, whose main function is to extend the knee joint and bend the thigh. Iliopsoas is composed of psoas major muscle and iliacus, which is mainly responsible for the external rotation of the thigh and forward flexion of the pelvis and trunk. The sartorius is flat and banded, and is one of the longest in the leg muscles, starting from the anterior superior iliac spine, passing through the inner side of the knee joint, and finally to the inner side of the upper end of the tibia. The main function of sartorius is for the bending of the hip and knee.
Imaging changes following surgery for ischiofemoral impingement
Published in Baylor University Medical Center Proceedings, 2023
Munif Hatem, Richard Feng, Jordan Teel, Hal David Martin
Atrophy of the iliacus and psoas muscles has been reported following iliopsoas tenotomy in association with hip arthroscopy.11,12 However, these studies reported no significant difference in the mHHS relative to the amount of atrophy.11,12 In the present study, no correlation between the mHHS and the amount of iliopsoas atrophy was observed. The primary function of the iliopsoas muscle is hip flexion, and tenotomy or detachment from the LT could result in hip flexion weakness. In the present study, one patient reported hip flexion weakness in the early postoperative period, which was resolved at 4-month follow-up. Previous studies have reported improvement of hip flexor weakness by at least 8 weeks postoperatively after iliopsoas tendon release.13,14 Brandenburg et al reported a 19% reduction in seated hip flexion strength following iliopsoas tenotomy at the level of the hip joint.15 Those authors also reported no significant difference in hip flexion strength in the supine position when comparing the operated with the nonoperated side.15 The reinsertion of the iliopsoas onto the femur following the LT resection could prevent flexor weakness. While the technique for iliopsoas reinsertion following LT resection is published, clinical results on hip flexor strength are not reported.16
Treatment of idiopathic meralgia paresthetica – is there reliable evidence yet?
Published in Neurological Research, 2023
The LCN originates within the lumbosacral plexus containing L2 and L3 nerve fibers. It runs in an oblique fashion in the lateral pelvis at the lateral border of the iliopsoas muscle. It then turns ventrally beneath the iliac muscle fascia towards the anterior superior iliac spina (ASIS) and continues from medial cranial to lateral caudal beneath the inguinal ligament. Four different types of courses are described (Figure 1). The most common types are 1 and 2: In type 1, the nerve cuts through both strings of the inguinal ligament, which is where it is compressed. In Type 2I, the LCN runs below the inguinal ligament, medial to the superior anterior iliac spina, and is compressed at the sharp end of the iliac fascia in a standing position. In Type 3, the nerve is compressed at the site where it traverses the sartorius muscle. In type 4, the LCN is compressed in a groove at the superior anterior iliac spine and lateral to the insertion of the inguinal ligament [13]. The LCN usually splits into two branches on the fascia of the thigh. A cadaver study in 33 specimens revealed an average distance of 8.8 mm between the ASIS and the LCN. The distance was less than 2 cm in 76% of cases [14]. The LCN only contains sensory fibers and innervates the area of the anterolateral thigh region.
Related Knowledge Centers
- Femoral Nerve
- Femur
- Iliacus Muscle
- Lesser Trochanter
- Lumbar Nerves
- Psoas Major Muscle
- Thigh
- Vertebra
- Abdomen
- Composite Muscle